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General NPI Number Information
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NPI Number | 1184763427
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Entity Type | Individual
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Provider Name | ADIB SETAREH DDS
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Gender | Male
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Dates
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Enumeration Date | 02/05/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1565 S WESTERN AVE
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City | LOS ANGELES
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State | CA
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Zip | 90006-4233
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Country | US
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Telephone | 323-734-9514
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Fax | 323-734-0465
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Provider Business Mailing Address
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Address Line | 18055 LAKE ENCINO DR
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City | ENCINO
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State | CA
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Zip | 91316-4431
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Country | US
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Telephone | 323-734-9514
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Fax | 323-734-0465
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 41545
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License Number State | CA
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